Roger Parot

CHU de Lyon - Hôpital Femme-Mère-Enfant, Lyons, Rhône-Alpes, France

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Publications (18)28.36 Total impact

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    ABSTRACT: Background: Surgical resection of a malignant tumor of the chest wall in children may result in the development of progressive scoliosis. The aim of this study was to identify the risk factors associated with scoliosis following resection of a tumor of the chest wall and to evaluate the prevalence and characteristics of the scoliosis. Methods: Forty children who underwent resection of a malignant tumor of the chest wall from 1984 to 2005 were included in a multicenter, retrospective cohort study. The mean age of the patients at the time of surgery was 9.8 years (range, 0.2 to nineteen years). Resections were classified with the use of the following scheme: the number of resected ribs was noted in Roman numerals, and the level of the resection was identified by dividing the thorax into three sectors (A [anterior], B [lateral], and C [posterior]) in the horizontal plane. One to five ribs (mean, 2.3 ribs) were resected. Patients with scoliosis were compared with patients who did not have scoliosis through the use of univariate and multivariate analyses. The mean duration of follow-up was 8.5 years (range, three to twenty-three years). Results: Patients who had a tumor resection during a rapid-growth period (patient age of less than six years or between twelve and fifteen years) had a 5.8 times higher risk of scoliosis. The resection of three or more ribs in the posterior sector (C) was the primary risk factor for scoliosis, with an odds ratio of 18.9. Seventeen (43%) of the children developed scoliosis, which was convex toward the resection side without vertebral rotation in all of them. Conclusions: The risk of scoliosis following the resection of a primary malignant tumor of the chest wall in children was shown to be higher when resection was performed during a rapid-growth period and when the resection involved three or more ribs in the posterior sector.
    No preview · Article · Jan 2014 · The Journal of Bone and Joint Surgery

  • No preview · Article · Nov 2012 · Revue de Chirurgie Orthopédique et Traumatologique

  • No preview · Article · Nov 2011 · Resuscitation

  • No preview · Article · Nov 2011 · Resuscitation
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    ABSTRACT: Nonoperative treatment avoids the complications after extensive surgery for idiopathic clubfeet. The purpose of this study was to compare retrospectively French physiotherapy and Ponseti method used to treat idiopathic clubfoot in 2 institutions. Two hundred nineteen idiopathic clubfeet (146 patients) managed during a 3-year period (2000 to 2003) were included in this study: 116 clubfeet in group FM were treated according to modified French physiotherapy (with percutaneous heel-cord tenotomy in 17%) and 103 clubfeet in group PM were treated according to the Ponseti method. The use of further surgery was considered as failure of the nonoperative management: complete posteromedial release were noted poor, limited posterior release were noted fair, and nonrelease surgery or nonoperated feet were scored with the modified Ghanem score. After a mean follow-up of 5.5 years (range, 2.5 to 7.4 y), similar rate of surgery was performed in both groups (21% in group FM and 16% in group PM) but complete posteromedial release was mainly done in group FM (19% of feet), and limited surgery was done in group PM. Results were noted excellent, good, fair, and poor in respectively 55%, 20%, 6%, and 19% of patients in group FM and 79%, 15%, 4%, and 2% of patients in group PM. Results for Dimeglio grade II clubfeet were not different, but results for grade III and grade IV clubfeet were better in PM group. Ponseti method enables reduction of extensive surgery compared with French physiotherapy mainly for severe deformities.
    Preview · Article · Apr 2011 · Journal of pediatric orthopedics
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    ABSTRACT: We asked whether locally applied recombinant-bone morphogenic protein-2 (rh-BMP-2) with a type I collagen carrier could enhance the consolidation phase in distraction osteogenesis and whether a dose effect could be reported. We performed unilateral transverse osteotomy of the tibia in 15 immature male rabbits. In Group I (five rabbits), 750 microg of rh-BMP-2 on the type I collagen sponge (Inductos, Medtronic) was locally applied on the day of osteotomy; the Group II animals (five rabbits) received 375 microg of the drug and the Group III (control group, five rabbits) had no local application. After 7 days, 3 weeks of distraction was begun at a rate of 0.5 mm/12 h. Starting week 2 of distraction, we assessed radiographic, ultrasonographic, and densitometric parameters once per week. Animals were sacrificed after a 3-week consolidation period. Radiographic evaluation revealed increased regenerate ossification in the rh-BMP-2 groups compared with the control group. The bone mineral content was significantly higher in the rh-BMP-2 treated groups at each time point. A dose effect is shown as densitometric parameters were significantly higher between Groups I and II. 3/5 of the Group I treated animals developed a premature bony union in the regenerate resulting in premature fusion and incomplete distraction.
    No preview · Article · Oct 2009 · Injury
  • Frédéric Sailhan · Franck Chotel · Roger Parot
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    ABSTRACT: Chondroblastoma is a rare benign bone lesion that occurs in young patients and has a high rate of recurrence. The purpose of the present study was to report on eighty-seven cases of chondroblastoma in children and to identify the possible factors that increase the risk of recurrence. We retrospectively reviewed eighty-seven cases of chondroblastoma in patients with open physes at the time of diagnosis and treatment. Historical data, complete imaging data, histological findings, and surgical charts were analyzed. Multiple logistic regression was used to identify predictors of recurrence. The series included fifty-three boys and thirty-four girls with a mean age of 12.5 years. Lesions were located in the epiphysis in 68% of the patients, especially in the proximal part of the tibia (twenty-four patients) and the proximal part of the femur (twenty-three patients). Pain was the presenting symptom in 84% of the patients. The treatment consisted of intralesional curettage with autogenous bone-grafting in 63% of the patients. The functional outcome at an average of 62.5 months of follow-up was good for 68.5% of the patients. At a minimum of twenty-four months of follow-up, 32% of the lesions had recurred. Sex, radiographic aggressiveness, an aneurysmal bone-cyst component on histological analysis, and the method of surgical treatment had no significant influence on recurrence. Epiphyseal chondroblastomas were associated with a higher risk of recurrence when compared with metaphyseal, apophyseal, and epiphyseal-metaphyseal lesions (p = 0.004). Chondroblastoma in growing children is most frequently located in the proximal part of the tibia and the proximal femoral epiphysis. The recurrence rate is high, particularly for strictly epiphyseal lesions. Proximal femoral lesions and tarsal lesions are associated with a poorer outcome.
    No preview · Article · Oct 2009 · The Journal of Bone and Joint Surgery
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    ABSTRACT: We have analysed the pattern of symptoms in patients presenting with synovial sarcoma to identify factors which led to long delays in diagnosis. In 35 children, the early symptoms and the results of clinical and radiological investigation were reviewed, along with the presumed diagnoses. The duration of symptoms was separated into patient delay and doctor delay. Only half of the patients had one or more of the four clinical findings suggestive of sarcoma according to the guidance of the National Institute for Clinical Excellence at the onset of symptoms. Of the 33 children for whom data were available, 16 (48.5%) presented with a painless mass and in ten (30.3%) no mass was identified. Seven (21.2%) had an unexplained joint contracture. Many had been extensively investigated unsuccessfully. The mean duration of symptoms was 98 weeks (2 to 364), the mean patient delay was 43 weeks (0 to 156) and the mean doctor delay was 50 weeks (0 to 362). The mean number of doctors seen before referral was three (1 to 6) and for 15 patients the diagnosis was obtained after unplanned excision. Tumours around the knee and elbow were associated with a longer duration of symptoms and longer doctor delay compared with those at other sites. Delays did not improve significantly over the period of our study of 21 years, and we were unable to show that delay in diagnosis led to a worse prognosis. Our findings highlight the variety of symptoms associated with synovial sarcoma and encourage greater awareness of this tumour as a potential diagnosis in childhood.
    Preview · Article · Sep 2008 · The Bone & Joint Journal
  • F Chotel · R Parot · J Bérard

    No preview · Article · Jul 2005 · Archives de Pédiatrie
  • F. Chotel · R. Parot · J. Bérard

    No preview · Article · Jun 2005 · Archives de Pédiatrie

  • No preview · Chapter · Dec 2004
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    ABSTRACT: The authors report four cases of Jeffery type 2 lesions in children. Despite the probable mechanism of such lesions, none of the cases reported here displayed a dislocation of the elbow. In the first observation the diagnosis was suspected only 15 days after injury. Two other cases were initially treated by closed external manipulations, one with percutaneous Kirschner wire leverage and the other with closed intramedullary pinning, but both cases displayed a 180 degree reversal of the radial head, suspected only secondarily. The first exhaustive review of the literature on the subject, shows that this complication is classical in Jeffery type 2 fractures. In fact none of the 22 cases described in the literature had successfully been reduced by external manipulations. Interposition of the lateral condyle, pathognomonic of the Jeffery type 2 fracture, hampers reduction. Attempts at reduction by external manipulation in nine cases therefore led to two non-reduction and seven reversal of the radial head. Knowledge of this particular fracture will allow an early diagnosis and an immediate surgical treatment.
    No preview · Article · Aug 2004 · Journal of Pediatric Orthopaedics B
  • E. Garnier · R. Parot · F. Chotel

    No preview · Article · Jan 2004 · Medecine Therapeutique Pediatrie
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    ABSTRACT: The choice of first-line treatment for congenital varus equine clubfoot remains a controversial issue largely dependent on experience. In France, functional treatment predominates. In 1948, Ponseti proposed reducing the deformity with successive casts. Although cast treatment is a very old method, Ponseti's method is original because it is based on strict rules established from anatomic evidence. The goal is not to correct the apparent deformation, but on the contrary to impose a simultaneous supination and abduction of the foot. Once the calcaneopedal block has been derotated, percutaneous tenotomy of the Achilles tendon is performed. We relate our experience with this method and recall the precise technique used to make the casts. After the cast, derotation braces are worn at night but rehabilitation exercises are not required. We emphasize the quality of the clinical reduction achieved as well as the smaller number of patients who require surgery at walking age.
    No preview · Article · Dec 2002 · Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur
  • R Parot · B de Billy · E Monnet · E Garnier · D Aubert
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    ABSTRACT: The objective of the study was to estimate prevalence of therapeutic complications in a department of orthopedics pediatric surgery, and to determine predictors of minor and serious complications. Between November 1996 and 1997, children less than or equal to 17 years of age, admitted for bone fracture (head and face excepted) were selected in a prospective study. In all, 700 children were treated until bone consolidation. Individual, socio-economic, anatomical, environmental and therapeutic factors were progressively registered. All complications were noted. The mean age of the children was 9.2 years; 25 patients could not be traced. Prevalence rate of therapeutic complications was 10.3%. In multivariate analysis using logistic regression, six factors increased the risk of adverse event: kind of fracture (diaphysial), comminuted aspect, compounded fracture and bone displacement, season (spring and autumn), and use of medical transport between accident place and hospital. The same factors, season and compounded fracture excepted, were predictors of serious complications. The results show that therapeutic complications depend on anatomical and environmental factors above all, and that medical procedure is not a prognosis factor. So if prevention of fractures is possible before injury, a better knowledge of initial risk can improve prevention of complications.
    No preview · Article · Oct 1999 · Revue d Épidémiologie et de Santé Publique
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    ABSTRACT: The number and severity of sports-related injuries in children have changed over recent years. In a study of 2 704 sports-related injuries in children younger than 15 years, these injuries accounted for 17.25% of visits to a pediatric surgical emergency room. Two-thirds of patients were boys. Soccer and contact sports in boys and gymnastic in girls were leading causes of sports-related injuries. Most of the injuries occurred during school activities. Soccer and cross-country biking contributed a significant number of injuries because of the large numbers of children who engage in these sports. Gymnastic, cross-country biking, and basketball were also important causes as a result of their high injury risk. Most injuries were nonserious; half were sprains or contusions. More severe lesions with fractures were seen with some sports such as cross-country biking, ice skating, basketball, and roller blading. The most severe injuries were caused by sports involving equipment associated with high-velocity displacement and the possibility of falling from a considerable height. Injury control relies in part on passive measures such as appropriate training of physicians, coaches, and other persons involved in sports with children. Evaluation of the psychomotor profile and morphology (endomorphic, ectomorphic, or mesomorphic of each child can help to identify the sports that will be most beneficial while involving the smallest possible risk of injury. The risk of injury is reduced when sporting activities are in harmony with the degree of maturity, the growth, the and developmental stage of the child.
    No preview · Article · May 1999 · Annales de pédiatrie
  • F. Chotel · R. Parot · Fassier

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  • J. Bérard · R. Parot

    No preview · Article ·

Publication Stats

115 Citations
28.36 Total Impact Points


  • 2002-2012
    • CHU de Lyon - Hôpital Femme-Mère-Enfant
      Lyons, Rhône-Alpes, France
  • 2011
    • Claude Bernard University Lyon 1
      Villeurbanne, Rhône-Alpes, France
  • 2009
    • Clinique du Val d'Ouest
      Écully, Rhône-Alpes, France
  • 2008
    • The Royal Orthopaedic Hospital NHS Foundation Trust
      Birmingham, England, United Kingdom